Only 22% of physicians participating in the CMS Physician Quality Reporting Initiative, or PQRI, were able to access the feedback report for their practice, according to an online survey of 408 doctors conducted in September by the American Medical Association.
More than 60% of the physicians surveyed rated the program as difficult and, according to an AMA news release, of the physicians who asked for assistance from the CMS, 59% of respondents rated their satisfaction with CMS responsiveness as none to low.
Of those who were able to access their feedback reports, less than half of respondents found them helpful, as doctors who began reporting in July 2007 did not get a report until 12 months later, halfway through the program's second year, which made it impossible to fix any reporting problems, the AMA said.
A CMS representative was not available to comment on the AMA survey, but in response to an earlier survey of medical group practice leaders conducted by the Medical Group Management Association, the CMS issued a written statement that said it regrets there was difficulty accessing confidential reports. But it added that most issues have been resolved and others continue to be addressedeither on the CMS PQRI Web site or through monthly outreach conference calls.
The CMS statement also addressed findings from the MGMA survey, which said that doctors were disappointed that the feedback reports lacked quality-improvement suggestions. It noted that, The reports are not intended to provide specific quality-improvement advice to physicians, but rather to provide information on reporting success and performance rates."
The general findings of the MGMA report were that doctors didnt find PQRI participation worthwhile but were participating anyway because they felt the program represented the future of the CMS reimbursement system and they had to learn how to use it.
According to the AMA, the CMS needs to place a greater emphasis on early education and feedback." In addition, Congress should allow the CMS to develop a process that allows physicians to appeal CMS judgments on inaccurate reporting.
"Physicians are committed to improving the quality of patient care, and the AMA is committed to working with policymakers to make this program a viable quality improvement tool for physicians," said AMA board member Ardis Hoven in a news release. "The AMA survey shows a clear need for the program to be improved so that physicians can more easily participate and so that they and Medicare get greater value from the program."
Only 40% of the AMA survey respondents who participated in the PQRI reported that they did receive a bonus.
"Physicians need to be confident that the effort they put into participating in the PQRI is worthwhile for both their patients and their practice," Hoven said.
The CMS reported in July that it would pay $36 million in bonuses for PQRI participants who submitted data on services provided between July and December 2007. A little more than half who participatedor about 56,700 out of about 109,000qualified for bonuses, which amounted to about $600 for individual practices and $4,700 for group practices.
Most of the MGMA respondents who participated reported receiving a bonus for reporting quality performance measures for the six months between July 1 and Dec. 31, 2007. According to the survey, 61.8% received bonuses, 8.6% did not, and 29.6% didn't know.
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